Emphysema is a chronic respiratory condition most often caused by the destruction of lung tissue by toxins contained in cigarette smoke. This in turn leads to chronic overinflation of the lungs, greatly decreasing their ability to function.

Like chronic bronchitis, emphysema is a chronic obstructive pulmonary disease (COPD) that evolves over a period of time. Emphysema results in destruction of the alveoli, the tiny air sacs in the lungs. Oxygen is delivered to the lungs and carbon dioxide is carried from the lungs across the walls of the alveoli. As more and more alveoli are damaged, it becomes harder and harder for the lungs to function, which can cause these symptoms:

  • Shortness of breath
  • Increasing difficulty exercising
  • Great difficulty exhaling
  • Chronic coughing
  • Tiredness and fatigue
  • Chest pain
  • Weight loss

As the disease progresses, breathing becomes increasingly difficult. In its most severe stage, virtually any physical activity becomes extremely difficult, if not impossible.

What Causes Emphysema?

According to Dr. Joseph Zibrack, associate director of pulmonary and critical care medicine at Boston's Beth Israel Deaconess Medical Center, "Like chronic bronchitis, over 90% of all cases of emphysema are caused by long-term smoking of cigarettes or other tobacco products. [In rare cases], emphysema is inherited and results from a deficiency of a protein known as alpha-1 proteinase inhibitor (alpha-1)."

Diagnosis and Treatment

When a patient complains of the chronic presence of the symptoms of emphysema, a physical exam and various lung capacity tests are done to confirm the diagnosis. Chest x-rays may also be done.

Since, at present, emphysema cannot be cured, the goals of treatment are to:

  • Relieve the symptoms of the disease
  • Prevent further loss of lung function

Relieving Symptoms

To relieve symptoms, one or more of the following treatments may be used:

  • Bronchodilator medicines—to help relax the lung's airways
  • Anticholinergic medicines—to help open the airway passages.
  • Breathing exercises and a physical conditioning program—to help improve lung capacity and general overall physical condition
  • Anti-inflammatory medicines (eg, corticosteroids)—to decrease inflammation and swelling in the breathing passages
  • Oxygen therapy—may be used for patients with severely impaired lung function.
  • Alpha 1-proteinase inhibitor—in rare cases where emphysema is caused by an inherited deficiency

Emphysema may also be treated with surgery, such as:

  • Bullectomy—removal of an area on the lungs
  • Lung volume reduction surgery—removal of seriously damaged part of the lung
  • Lung transplant

Stop Smoking

To slow emphysema's progression, the agent causing it must be removed. And since long-term smoking causes the overwhelming number of cases of emphysema, the only effective way to slow the progression of emphysema is to quit smoking.

Prevention

To prevent the onset (or worsening) of emphysema, take the following steps:

  • If you smoke, quit. Talk to your doctor about strategies to quit.
  • Avoid workplace and environmental pollutants.
  • Take measures to avoid colds and the flu (including a yearly flu vaccine).
  • Seek treatment at the earliest sign of any lung infection or if you have trouble breathing.
  • Exercise regularly and eat a healthy diet to help strengthen your immune system.
  • Avoid extremes of temperature and altitude.

Emphysema does not suddenly occur. It develops over a long period of time. Unfortunately, many sufferers ignore their condition until it becomes serious, at which point treatment options are less effective. Therefore, at the first sign of any of the symptoms, talk to your doctor.